Mental Health Law: Reform in England & Wales in 2023

In 2022 the Mental Health Bill was published in England & Wales. It heralded a much-needed period of debate in the UK about the status of our mental health laws and their suitability for the 2020s and beyond.

White Paper

In June 2022 the Mental Health Reform Bill was published and has now reached the Committee stage, which means that it is being scrutinized by a Joint Parliamentary Committee. The Committee published its findings in January 2023.

Aim of the Bill

The Bill’s aim is to give patients more say in what happens to them when they are ill, who is involved in their care and what treatment they are given. The patient’s wishes will basically be set at the centre of the mental health admission process.

Mental Health & Hospitalisation

People will only need to be hospitalized if there is a very high risk they will hurt themselves, not get better unless they go into hospital, or hurt other people.

Talking to doctors and a treatment plan

At times when patients have capacity (in other words when they are well), patients will have a right to talk to doctors and formulate a treatment plan for when they are unwell. The plan should state who is involved in your treatment and what care you should be given. You can appoint a nominated person to be your advocate, who need not be your next of kin.

Mental Health Tribunal

You can apply to a tribunal to determine if you need to stay in hospital. As such they are a crucial device in the mental health system. There will be more tribunals to speed up the process, making sure there are fewer delays causing people to stay in hospital when they do not need to.

Criminal law

Where someone has been hospitalized under criminal law, there will be increased opportunities for them to leave hospital if their condition has improved and they no longer need to be in hospital. They will instead be treated in their local community where possible.

People with learning disabilities and autism

People with learning disabilities and autism who have mental health conditions will be treated with more respect under the Mental Health Reform Bill. They will have a care, treatment and education review to see if their condition might be more appropriately treated in the community so they don’t have to stay in hospital.

Community Treatment Orders

When you have left hospital you may need a CTO to continue your treatment in aftercare; and the CTO will explain what treatment you need after being in hospital to keep you safe at home. The Committee also hopes the Bill will tackle certain racial inequalities apparent in the use of CTOs.

Committee Stage

The Bill was structured around four guiding principles:

· Choice and autonomy

· Least restriction

· Therapeutic benefit

· The person as an individual.

The Joint Parliamentary Committee reported in January 2023 on the Mental Health Reform Bill. It has suggested having the four principles stated on the face of the Bill and has made numerous suggestions about how to tackle racial inequalities within the mental health care system.

Mental Health Commissioner

The Committee Report recommends the creation of a new Mental Health Commissioner who will oversee and push forward the reforms and be an advocate for proper resourcing.

Conclusion

If you are affected by or interested in mental health then this is an exciting and propitious time. The Bill sets out some extremely welcome reforms, putting the patient’s wishes and needs first. The Joint Parliamentary Committee Report seems thorough and welcome, and if the Committee’s recommendations are followed the Bill should provide some strong and enlightened legislation that will provide a positive framework for mental health going forward.

The Successity Blog will focus on a few of the relevant issues in more detail in the coming months as the Bill progresses.